File note

Dear A and D

Diagnosis:
1. Primary infertility secondary to azoospermia post vasectomy reversal
2. Unsuccessful first IVF cycle
3. Hypertrophic obstructive cardiomyopathy, treated cardiac septal ablation, 1998 and 1999, second procedure complicated by vascular injury requiring double bypass graft
4. Allergy to aspirin and ibuprofen
5. Dysmenorrhoea, possibly due to endometriosis
6. Short menstrual cycle


A and D were seen for review following their recent unsuccessful frozen embryo transfer cycle in January this year. They are understandably disappointed at the outcome, but they are keen to proceed with a further publicly funded IVF cycle. A's menstrual cycle remains short at between 21 and 23 days, she tends to ovulate around day 11 of her cycle. On this occasion we will treat A with a long down regulation cycle with a slightly higher dose of Gonal-F in the stimulation phase. A will book on for treatment with her next menstrual period and I remain optimistic that a pregnancy will be achieved for this couple.

Yours sincerely ...